Transoral Incisionless Fundoplication (TIF) Versus Sham for Treatment of Gastroesophageal Reflux Disease (GERD)
A Randomized Controlled Trial Comparing Transoral Incisionless Fundoplication (TIF) Using EsophyX With Sham Procedure for the Treatment of PPI Dependent GERD: the TIF vs. Sham Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Primary Effectiveness Endpoint: The proportion of patients in clinical remission after 6 months (without being classified as treatment failure).
Secondary Effectiveness: PPI consumption, esophageal acid exposure, reduction in QOLRAD and GSRS scores and healing of reflux esophagitis.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 18-80 years
- On daily PPIs for > 6 months
- Documented PPI dependency
- Persistent GERD symptoms without PPI therapy during the titration phase of the study
- Evidence of two or more of the following while off PPI therapy (> 10 days):
- Erosive esophagitis (Los Angeles grade A-C)
- Abnormal ambulatory pH study
- Moderate to severe GERD symptoms
- Normal or near normal esophageal motility (by manometry)
- Patient willing to cooperate with post-operative dietary recommendations and assessment tests
- Signed informed consent
Exclusion Criteria:
- BMI > 35
- Hiatal hernia > 3 cm
- Esophagitis LA grade D
- Esophageal ulcer
- Esophageal stricture
- Barretts esophagus (Prague: C>1, M>2)
- Esophageal motility disorder
- Severe gastric paralysis
- Pregnancy or plans for pregnancy in the next 12 months
- Immunosuppression
- ASA > 2
- Portal hypertension and/or varices
- History of previous resective gastric or esophageal surgery, cervical spine fusion, Zenker's diverticulum, esophageal epiphrenic diverticulum, achalasia, scleroderma or dermatomyositis, eosinophilic esophagitis, or cirrhosis
- Active gastro-duodenal ulcer disease
- Gastric outlet obstruction or stenosis
- Severe gastroparesis or delayed gastric emptying confirmed by solid-phase gastric emptying study if patient complains of postprandial satiety during assessment
- Coagulation disorders
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: TIF procedure
Transoral Incisionless Fundoplication (TIF)
|
The TIF procedure results in the creation of an esophago-gastric fundoplication extending up to 4 cm above the Z-line and 270 degress around the esophagus.
|
|
Sham Comparator: Sham procedure
The intervention on the Sham procedure consisted of an upper gastrointestinal endoscopy, or EGD.(esophagogastricduodenoscopy).
|
The TIF procedure results in the creation of an esophago-gastric fundoplication extending up to 4 cm above the Z-line and 270 degress around the esophagus.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of patients in clinical remission
Time Frame: at 6 month follow-up
|
Fifty nine per cent of patients remained in clinical remission
|
at 6 month follow-up
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Reduction in symptoms
Time Frame: at 6 moths follow-up
|
GSRS score improved from 14 (range 10-21) to 10 (range 6-19) with P = 0.004.
|
at 6 moths follow-up
|
|
Normalized esophageal acid exposure
Time Frame: at 6 months follow-up
|
Sixty nine per cent of patients (69%) in TIF surgical arm normalized esophageal acid exposure.
|
at 6 months follow-up
|
|
Healed reflux esophagitis
Time Frame: at 6 months follow-up
|
In 80% of patients healing of esophagitis was observed
|
at 6 months follow-up
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Lars Lundell, M.D., Karolinska University, Huddinge Hospital, Stockholm, Sweden
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Gastrointestinal Diseases
- Stomach Diseases
- Gastroenteritis
- Intestinal Diseases
- Pathological Conditions, Anatomical
- Esophageal Motility Disorders
- Deglutition Disorders
- Esophageal Diseases
- Esophagitis
- Peptic Ulcer
- Duodenal Diseases
- Hernia, Diaphragmatic
- Internal Hernia
- Hernia
- Gastroesophageal Reflux
- Esophagitis, Peptic
- Hernia, Hiatal
Other Study ID Numbers
Other Study ID Numbers
- D2009-10
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